Original Investigation

Accuracy of Sentinel Lymph Node Biopsy to Predict Nodal Metastasis in Head and Neck Merkel Cell Carcinoma

JAMA Otolaryngology–Head & Neck Surgery 10.1001/jamaoto.2025.5211

January 29, 2026 at 11:00 AM EST

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What is the accuracy of sentinel lymph node biopsy (SLNB) in head and neck Merkel cell carcinoma?This single-center retrospective cohort study of 69 patients with clinically node-negative head and neck Merkel cell carcinoma who underwent SLNB found that occult nodal disease was present in 19 patients (27.5%). SLNB sensitivity was 52.6% (10 of 19 patients), with high rates of failed SLNB (29.0%; 20 of 69 patients) and false negative SLNB (26.7%; 4 of 15 patients).These findings suggest that patients with failed SLNB or those with negative SLNB but high-risk features may benefit from tailored therapy and surveillance strategies.

Corresponding Author: Ryan M. Carey, MD, Department of Otorhinolaryngology−Head and Neck Surgery, University of Pennsylvania Medical Center, 3400 Spruce St, Ravdin Building, 5th Floor, Philadelphia, PA 19104 (ryan.carey@pennmedicine.upenn.edu).

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